Document Detail


Endoscopic Extracapsular Dissection for Resection of Pituitary Macroadenomas: Technical Note.
MedLine Citation:
PMID:  23034885     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective With the increasing use of the endoscope in neurosurgery, transsphenoidal surgery has undergone a considerable technical evolution. However, most recently reported advances relate to the approach to the sella turcica or to extended transsphenoidal approaches, whereas the dissection technique for pituitary tumor removal itself has received more limited attention. A notable exception is Oldfield's elegant description of an extracapsular dissection of functional pituitary microadenomas. Our objective is to describe and illustrate our technique for endoscopic extracapsular resection of pituitary macroadenomas.Methods Influenced by Oldfield's description, we have adopted an extracapsular dissection technique in the endoscopic resection of pituitary macroadenomas. After carefully opening the dura without disrupting the macroadenoma pseudocapsule, the pseudocapsule is dissected inferiorly and laterally. The tumor is then internally debulked and the extracapsular dissection is extended circumferentially; the resection is then complete.Results The enhanced visualization and illumination afforded by the endoscope enables the identification and surgical dissection of the pseudocapsule at the periphery of the macroadenomas under direct vision in most cases. As demonstrated in the illustrative case, working around the macroadenoma pseudocapsule allows for a definitive and complete macroadenoma resection with direct visual confirmation and with preservation of the normal gland and diaphragma.Conclusion The endoscopic transsphenoidal approach permits an extracapsular dissection of many pituitary macroadenomas. In our preliminary experience, this technique appears to result in a high rate of complete resection without an increase in complications.
Authors:
Roukoz Chamoun; Masayoshi Takashima; Daniel Yoshor
Related Documents :
22748895 - Acute appendicitis in pregnancy: specific features of diagnosis and treatment.
24530575 - Endovascular repair of acute traumatic aortic injury: experience of a level-1 trauma ce...
24360075 - Adductor longus tendon rupture mistaken for incarcerated inguinal hernia.
22469495 - Peri-operative complications after adenotonsillectomy in a uk pediatric tertiary referr...
7352305 - Late genitourinary tract complications associated with severe pelvic injury.
12421795 - Hoof kick injuries in unmounted equestrians. improving accident analysis and prevention...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-3
Journal Detail:
Title:  Journal of neurological surgery. Part A, Central European neurosurgery     Volume:  -     ISSN:  2193-6323     ISO Abbreviation:  J Neurol Surg A Cent Eur Neurosurg     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101580767     Medline TA:  J Neurol Surg A Cent Eur Neurosurg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Affiliation:
Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, United States.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Neuronavigation in Endonasal Pituitary and Skull Base Surgery Using an Autoregistration Mask without...
Next Document:  An Unusual Sacral Osteomyelitis Due to an Occult Anterior Sacral Meningocele.